Hand hygiene involves the proper washing of your hands. It is one of the most important strategies in preventing healthcare-associated infections. It is a key part of basic safety and infection prevention.
Access to handwashing facilities can affect how healthcare-associated infections spread. This includes soap and water, and alcohol-based hand rubs.
Wash your hands with soap and water if you observe that they are dirty. You can use either product if your hands appear clean.
When should I perform hand hygiene?
Always perform hand hygiene;
- before touching a patient,
- before a procedure,
- after a procedure or after exposure to blood or body substances,
- after touching a patient,
- after touching a patient’s surroundings,
- when hands are dirty or after using the bathroom, and
- before putting on gloves and after the removal of gloves.
2. Wear gloves
Gloves create a barrier between germs and your hands. Wearing gloves in the hospital helps prevent the spread of germs.
Wear gloves every time you touch;
- blood,
- bodily fluids,
- bodily tissues,
- mucous membranes, or
- broken skin.
You should wear gloves for this sort of contact, even if a patient seems healthy and has no signs of any germs.
As health services, what should I prepare?
Health services should make sure that staff have access to examination gloves. These gloves should match each staff member's preference and fit-test profile.
Gloves used in healthcare, aged care, and supported accommodation must be medical grade. They must meet AS/NZS 4011 and ISO 11193 standards for single-use medical exam gloves.
Vinyl gloves are not recommended for clinical care.
If I wear gloves, do I need to perform hand hygiene?
Yes, you must perform hand hygiene before putting on gloves and after removing gloves.
If your gloves are damaged;
- like if they are torn or have a hole, or
- if you see dirt on your hands even while wearing gloves,
You should wash your hands with soap and water. This will help remove any possible spores. After washing, dry your hands using a single-use towel until they are completely dry.
If gloves have been worn and they are not damaged, the hands are likely less contaminated. Given this, you can use an alcohol-based hand rub for hand hygiene.
3. Wear respirators
For patients:
Patients must always wear masks when they are outside of the isolation room. This includes times during transfers, procedures, or tests. P2/N95 respirators provide better protection and should be worn where it's safe to do so.
For healthcare staff:
It's recommended that, all staff should wear P2/N95 respirators in areas where they are near patients. This includes nurses' stations and admin areas in wards.
When the risk of COVID-19 is high, everyone must wear these respirators. If the risk is low, staff can choose to wear either a surgical mask or a P2/N95 respirator..
As health services, what should I prepare?
Health services should provide P2/N95 respirators for staff. The respirators should match each staff member's:
- preferences and,
- fit test or fit check profile.
Are P2 respirators and N95 respirators the same thing?
“P2 respirator” and “N95 respirator” are often used the same way in healthcare. But, they must meet different standards.
- In Australia, the standards for P2 respirators are stated in Standard AS/NZS 1716: 2012.
- While the N95 respirators are specified by US NIOSH.
4. Perform fit test and fit checking
For a P2 respirator to provide the best protection, the wearer must be properly fitted. They also need to be trained on how to use it safely. Healthcare workers should check each other's mask fittings. If they see any problems, they should report them right away. This keeps both workers and patients safe.
Staff training in high-risk areas should include risk management. This helps them understand the risks. It also teaches them how to fit the P2 respirator correctly. They should also check the fit when they use it. Fit testing can help find the right size and style of P2 respirator for each person.
5. Routine cleaning
Routine cleaning refers to cleaning with detergent and water. And then followed by rinsing and drying. It is the most useful method for removing germs from surfaces.
- Detergents help loosen the germs so that you can rinse them away with clean water.
- Scrubbing the surface reduces the number of germs on the surface.
- Rinsing with clean water washes away the loosened germs and any leftover detergent.
- Drying the surface makes it harder for germs to survive and grow.
6. Use TGA-listed hospital-grade disinfectant
Australian guidelines now recommend using TGA-listed hospital-grade disinfectants instead of TGA-registered ones.
Before, hard surface disinfectants were labelled “TGA-registered.” This meant they were effective at killing specific germs. But they had to go through a lot of tests and rules before they could be used in hospitals.
Now, those hard surface disinfectants are labelled “TGA-listed.” They don’t need to go through all those strict tests anymore, which makes it easier for hospitals to get them.
They might not have gone through as many strict tests, but they still meet certain standards to be safe and effective for general cleaning. They are still good at killing germs, but they might not have specific claims about which germs they can kill.
It’s good because now hospitals can have more choices of disinfectants to keep things clean and safe. Even if the disinfectants don’t have the strict sticker, they can still work well to kill germs.
As health services, what should I prepare?
Health services should maintain a consistent supply of TGA-listed disinfectants. This ensures that staff have easy access to products for cleaning and infection control.
When should disinfectants be used?
Disinfectants are usually needed if a surface has been cleaned with detergent and water but might still be contaminated. This contamination can come from germs that are hard to kill. Or from infectious materials like blood and bodily fluids.
Most germs do not live long on clean surfaces when exposed to air and light. Routine cleaning with detergent and water should lower the number of germs.
Disinfectants can be used after routine cleaning if there is an outbreak of a disease, like a gastrointestinal illness.
Why can’t a disinfectant or a 2-in-1 detergent/disinfectant product be used for routine cleaning?
Routine cleaning requires manual or mechanical effort. Sole reliance on a disinfectant without this mechanical/manual cleaning is not recommended.
High-level disinfectants or liquid chemical sterilants should not be used for general cleaning. Using them this way goes against the manufacturer’s instructions. It can be dangerous.
7. Prevent Antimicrobial resistance
Antimicrobial resistance is a serious health problem worldwide. It happens when germs resist medicines like antibiotics or antiviral drugs. When this occurs, treatments stop working, and harmful germs can survive.
In Australia and around the world, infection prevention and control are important. They help us fight antimicrobial resistance. By stopping infections, we can decrease the need for these medicines.
This, in turn, lowers the chances for germs to become resistant. Vaccination can also help. It prevents diseases and lowers the number of viral infections. Which are sometimes wrongly treated with antimicrobial drugs.
8. Replace peripheral intravenous catheters (PIVCs) routinely
Invasive medical devices often cause healthcare-associated infections. They allow germs to enter the body. These devices should only be used when necessary for medical reasons.
Healthcare facilities should create policies for replacing PIVCs based on a formal risk assessment. After evaluating the risks, healthcare facilities can choose one of the following two options for adults:
- Option 1: Replace a PIVC every 72 hours
- Option 2: Replace a PIVC based on clinical indication.
PIVCs should not be routinely replaced in neonates and children.
Other Methods
Wear PPE
PPE protects the healthcare worker from exposure to blood and body fluids/substances. PPE that meet Australian Standards, should be readily available and accessible.
PPE include:
- gloves,
- gowns,
- shoe covers,
- head covers,
- masks,
- respirators,
- eye protection,
- face shields,
- goggles
Reference: https://www.nhmrc.gov.au/sites/default/files/docu...
